Filed 3/14/23 Conservatorship of Bryan B. CA1/3
NOT TO BE PUBLISHED IN OFFICIAL REPORTS
California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for
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THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
FIRST APPELLATE DISTRICT
DIVISION THREE
Conservatorship of the Person
of BRYAN B.
PUBLIC GUARDIAN OF CONTRA A166229
COSTA COUNTY,
Petitioner and Respondent, (Contra Costa County
Super. Ct. No. P2000426)
v.
BRYAN B.,
Objector and Appellant.
In August 2022, the trial court reappointed a conservator for Bryan B.
under the Lanterman-Petris-Short Act (LPS Act; Welf. & Inst. Code, § 5000
et seq.; all statutory references are to this code) and removed his right to
make medical decisions regarding his grave disability, including his right to
refuse prescribed psychotropic medication. Bryan appeals, contending
insufficient evidence supports the order depriving him of his right to refuse
such medication. We affirm.
BACKGROUND
In July 2020, the trial court found Bryan gravely disabled, appointed
the Public Guardian of Contra Costa County (Public Guardian) as
conservator of Bryan’s person, and empowered the Public Guardian to place
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him in a locked facility and make medical decisions on his behalf relating to
his grave disability. Thereafter — most recently in June 2022 — the Public
Guardian petitioned to be reappointed as conservator and requested the court
limit Bryan’s right to refuse or consent to medical treatment, including
psychotropic medication. Bryan opposed the petition. At an August 2022
bench trial, the court admitted several exhibits, including Bryan’s medical
records. His conservator, psychologist Melinda Shrock, testified as an expert
in evaluating grave disability. She diagnosed Bryan with schizophrenia and
a mood disorder, the symptoms of which prevent him from being able to
provide for his food, clothing, or shelter. He is currently housed in a locked
medical facility where he is administered several psychiatric medications.
Bryan has aggressive outbursts and experiences delusions; he also has
difficulty with basic conversation — more than once, he couldn’t remember
what Shrock said, which she attributed to “an interruption of his thought
process” or a “preoccupation with voices.”
Shrock opined Bryan is gravely disabled because of his schizophrenia
and mood disorder. He lacks an understanding of his mental illness — he
“does not believe he’s mentally ill.” He also lacks insight into his need for
psychiatric medication — he “does not believe he needs” medication, and he
has expressed a desire to discontinue taking it. Bryan requires supervision to
ensure he takes his medication — on one occasion he threatened violence
against anyone who tried to inject him with antipsychotic medicine.
At the conclusion of trial, the trial court found beyond a reasonable
doubt that Bryan remained gravely disabled as a result of a mental disorder.
It reappointed the Public Guardian as conservator of Bryan’s person for
a one-year period and, as relevant here, precluded him from refusing
treatment regarding his grave disability, including psychotropic medication.
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DISCUSSION
Bryan’s sole contention on appeal is that insufficient evidence supports
the trial court’s order depriving him of his right to refuse psychotropic
medication. We disagree.
A trial court may establish or renew a conservatorship under the LPS
Act if a person is “gravely disabled,” meaning the person — because of
a mental health disorder — is unable to provide for their basic personal needs
for food, clothing, or shelter. (§§ 5350, 5008, subd. (h)(1)(A).) It may also
impose various legal “disabilities” on the conservatee, including a limitation
on the conservatee’s right to refuse or consent to treatment related to
their grave disability. (§ 5357, subd. (d); Conservatorship of S.A. (2020)
57 Cal.App.5th 48, 55 (S.A.).) By itself, a finding of grave disability does not
justify imposing an order authorizing involuntary medical treatment. (S.A.,
at p. 55.) Such an order is appropriate only if the moving party presents
clear and convincing evidence the conservatee is incompetent to give or
withhold informed consent. (Ibid.) In determining whether to impose an
order restricting a conservatee’s right to refuse or consent to treatment, the
court must consider whether the conservatee is aware of their situation;
whether they can understand the benefits and risks of — and alternatives
to — the proposed treatment; and whether they can understand and evaluate
the information necessary for informed consent and participate in the
treatment decision using a rational thought process. (In re Qawi (2004)
32 Cal.4th 1, 14, 17–18; S.A., at p. 56.) We review an order restricting
a conservatee’s right to refuse or consent to treatment for substantial
evidence, taking into account the clear and convincing standard of proof.
(S.A., at p. 56.) We do not, however, reweigh the evidence. (Ibid.;
Conservatorship of O.B. (2020) 9 Cal.5th 989, 1005, 1008.)
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Substantial evidence supports the restriction on Bryan’s right to refuse
or consent to treatment related to his grave disability, including his right to
refuse psychotropic medication. The Public Guardian offered undisputed
evidence Bryan has schizophrenia and a mood disorder, yet he denied having
a mental illness or needing to take prescribed antipsychotic medication for
that illness. It also offered uncontroverted evidence Bryan needed “extensive
support” to keep up with his medication regimen, and that he had difficulty
understanding basic conversation. Thus, the record amply supports
a conclusion by clear and convincing evidence Bryan did not understand
his situation or the benefits and risks of treatment, and that he could not
intelligently evaluate information about treatment or rationally participate
in treatment decisions. (S.A., supra, 57 Cal.App.5th at p. 56; Conservatorship
of D.C. (2019) 39 Cal.App.5th 487, 494–495; Conservatorship of Amanda B.
(2007) 149 Cal.App.4th 342, 349–351.)
Bryan’s arguments to the contrary are unavailing. For example, he
points to the absence of evidence that he has refused to take his psychiatric
medication and asserts the restriction is unnecessary while he is in a locked
facility. This argument misses the point. Bryan’s grudging compliance with
his medication regimen in a supervised setting does not undermine the
undisputed evidence he is incompetent to give or withhold informed consent.
He also briefly suggests that depriving him of the ability to consent to or
refuse treatment prevents him from demonstrating in future conservatorship
proceedings he is not gravely disabled. Not so. In a petition to reappoint
a conservator pursuant to the LPS Act, the Public Guardian must show
Bryan is unable to provide for his basic personal needs for food, clothing, or
shelter as a result of a mental disorder. (§§ 5350, 5008, subd. (h)(1)(A).)
Providing necessary treatment to a gravely disabled conservatee now does
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not lessen the Public Guardian’s burden if it files a future petition. Finally,
the restriction on Bryan’s right to refuse or consent to treatment related to
his grave disability — imposed at the conclusion of a bench trial — does
not violate his right to due process. (Compare K.G. v. Meredith (2012)
204 Cal.App.4th 164, 181–185.)
DISPOSITION
The August 2022 order is affirmed.
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_________________________
Rodríguez, J.
WE CONCUR:
_________________________
Fujisaki, Acting P. J.
_________________________
Petrou, J.
A166229
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